Should I file a state complaint against a hospital nurse who had a meltdown in my Dad's room.

by your 4th sentence you already have the hospital pegged as a bunch of idiots . in light of that , i only expected the story to get progressively worse . it reminds me of the guy who just hired me to build a chimney then wanted to dispute me on every detail . he'll be building his own chimney needless to say .

Captain has a way of putting things that make perfect sense, doesn't he?

Through many, many years of being a caregiver to both of my parents and being a nurse I have learned that there is a line between advocating on behalf of someone and alienating the support people who help our loved ones. It took me a while to find that line.

PS - Probably go through the hospital grievance procedures first. They are supposed to have those posted and yes, that should be done prior to notifying outside agencies; many places will provide counseling and help for employees like this.

I read and re-read, and honestly, under the circumstances, don;t see where you were out of line for asking for BP check before meds - I mean as long as what you said was more like "My dad has a lot of trouble with any changes in his BP meds - he needs to maintain x/y BP to feel OK and not pass out or fall - and we just always check first because you can't un-give a med" rather than "you idiots always screw up and now you're gonna do it again to him!"

To those people who provided constructive answers, I thank you. To the others who took offense to me being critical of the care he has received, you weren't there. My Dad has been in the hospital four times this year, three of those due to medical error, all from this hospital. I have very excellent doctors outside of this hospital caring for my father who see him regularly and keep him healthy. Each and every time he has been hospitalized it is because the hospitalists have not followed those doctors instructions for medication. This nurse refused to follow the treatment plan that was put in place by the admitting doctors. Had I not been there to stop her, the medication that she had in the tray ready to give to my father would probably have at the very least caused a stroke or death. So yes, I am very critical of a system that will allow this very same problem to occur three times in less than eight months. The question is, how do I get it to stop, and being nice about it obviously doesn't work. Since the hospitalists will not talk to his regular physicians, we can go anywhere we want and we won't be going back.

You can't sue someone for yelling. Well, you can sue them, but you won't win a tinker. I'd think long and hard about my contribution to this incident before I filed a formal complaint that could cost her her job.

Let me start by saying that being such a micromanaging control freak about your father is only going to result in a bad outcome every time. If you want your father taken care of the way YOU want him taken care of, you should hire around the clock private duty nurses to follow your orders. Your father isn't the only patient the hospital staff nurses have to take care of. The nurse had an "emotional meltdown"? If you were acting toward her the way you are speaking in this post, she could probably only take so much before she blew a gasket. Starting off by "pitching a fit" over the phone about his night meds was the start of a very bad thing, for you. And, since you state that your were there during the night shift, you already got special priviliges---usually, families don't stay during the night. Demanding to speak to administration in the middle of the night is ridiculous---the hospital administration is there during the day. You could have called up the next day & made an appointment to meet with hospital administration.

You say that you "refused to allow her to review the medication before the BP." Who are you to "refuse" to allow the nurse to do ANYTHING? Not all meds need a blood pressure taken before administration. Perhaps you should bone up on which meds require blood pressures & which don't before giving the nurse a hard time. You're not the one that determines what the parameters are for blood pressure readings---the doctor does. If your father was severely dehydrated, that would be the reason that his blood pressure did not go back to normal---it wasn't the clonidine. Clonidine peaks in 3 to 5 hours with a half life of 12 to 16 hours. The clonidine was far gone from your father's system in 24 hours. Don't be so obsessed with your father's blood pressure----the dehydration was the problem, not the B/P meds. Maybe you should go to nursing school so you can learn about this stuff.

The nurse blew a gasket because you were micromanaging your father's care & driving everybody crazy. Unless you have some sort of medical education or training, you have no right to micromanage anyone. I have an 85 year old mother who has been in the hospital 3 or 4 times in the last 5 years for serious medical issues, where she was admitted for at least a week each time. I am a master's/graduate level educated nurse anesthetist with 25+ years of experience & I would never consider telling a nurse or doctor what to do with her. Unless it is something blatantly dangerous, there is no reason to micromanage the care providers. And involving hospital administration for your father's readmission to the hospital is absurd. They have nothing to do with anything. In fact, I bet they were all rolling their eyes behind your back, not believing that they had to deal with the stupidity.

Be very careful about reporting the nurse to the board of nursing. I'm not saying that yelling was appropriate, but maybe she just couldn't take it anymore, being told what to do by you. Sometimes a person can only take so much, especially when they are being ordered around by a family member. You said that you "pitched a fit" on the phone----I take that as yelling at the person on the other end of the phone, as well as threatening them by saying "don't make me come back there". Why is that okay, yet a nurse yelling at you isn't? Your behavior toward the staff was uncalled for right from the beginning & you had no right to yell at them over the phone for not doing what YOU wanted them to do. Doctors & nurses don't take orders from the patient's family---that is lesson #1 that you need to learn. The nurse can come back & sue you for harassment if you report her to the board unnecessarily. And she's got witnesses to verify what happened at the scene. You don't.

Your father is 91 years old. You care about him. However, the doctors & nurses do not require your consent for every move they make----they're doing the best they can do to take care of him the best that they can. They are not required to call you every time his B/P is high or when it is low to get your permission to treat it. They had reasons for not adhering to his "medication regimen", like the fact that he was dehydrated from the diarrhea & his blood pressure was most likely already low from that. Taking him home against medical advice was an irresponsible thing to do---you do not have access to the emergency meds & machines to treat him in case something happens like the hospital does. Your demand that a "very precise treatment plan" be in place to consent to the admission is rather ridiculous. Treatment plans change all the time, based on the patient's response to the current treatment----and, here's a news flash: The doctor's don't need your consent to change the treatment plan for your father!! The human body is a dynamic machine, meaning that it is always changing & the treatment changes according to the body's responses.

Nurses have emotions too. They also have an EXTREMELY stressful & busy job to do. Plus, nurses are not stupid----they know their job. The last thing a nurse needs is a family member telling her what to do & micromanaging the care of your father. You have the freedom to hire a private duty nurse if you are not satisfied with the hospital staff nurses.

You have every right to be an advocate for your dad. As someone above stated make sure the drug in question is on your dads medicine list as a do not give. I would definitely go thru the necessary channels to report this nurse to the hospital. Sit down and write dates and times and document the incident . After your dad is released I would start the complaint process. My mom had a horrible nurse in s nursing home for rehab/broken wrist. My sister contacted the necessary people , wrote letters, documented events, etc. after about a month we were told this nurse had been let go. The administration admitted that she was in the wrong field. She did not have the compassion to take care of the elderly. The hospital had numerous incidents with this woman but no patient's family had pursue the issue in writing . Good luck with whatever you decide to do.

Phewf. There are some people who bitterly resent being told what to do. Regrettably, a few of them are nurses. You might think they'd be happier in a job where the ability to follow instructions To The Letter is not so critical, and so would I, but I suppose some people are born to trouble as the sparks fly upward…

Reading your account of that lively evening, I can't see what you could have done differently that would have made this lady-nurse any less determined to have her own way come hell or high water. If I have a further concern, it's that her supervisor(s) weren't more competent in defusing the situation more quickly. But seeing as this is the kind of hospital that it takes the patient some weeks to recover from, it can't have been a surprise to you.

File a complaint? - against the individual seems a bit OTT to me. What she did was not only fail, but actively refuse, to follow charted directions; not because she disagreed with them, but simply out of a stubborn refusal to listen to her patient's relative. Now while that is unprofessional, I agree, it's a disciplinary matter that ought properly to be dealt with by her line managers. It is they I would want held to account, because her whole stinky attitude is a reflection of their apparent willingness to dismiss all external information. It's the hospital that's the issue, not Nurse Snitty.

In your place I would document every adverse incident that has taken place and submit a formal complaint to the hospital. And then keep doing that until something changed. There's a hospital in ?California - is it San Diego? - that has reduced its error rate by some fantastic percentage by allowing its staff to report absolutely every error, glitch, oversight and failure of communication without fear of comeback; we patient advocates need a lot more of their self-reflective, constructive criticism and a lot less bloody-minded backchat.

TooYoung, I'd be interested to hear your recommendations for this (bear with me while I explain).

Say you have a parent, a child, spouse, whatever, who has complex co-morbidities. And say it is your experience, your actual as in it has already happened experience, that every single time your loved one is admitted to hospital there is a foul up. Every single time. Nothing catastrophic, just something that it takes a while to get straightened out again, because something comparatively minor has been overlooked. With me so far?

Okay, so given your long experience, which I respect, how *should* one act as that patient's advocate in a way that avoids pissing off a stressed, overworked nurse. How do you get people to give the devilish details that extra bit of attention without being unreasonable? What would you consider an acceptable approach?

If the treatment plan was written in the record and the nurse was not following the treatment plan, the the patient's daughter is not "meddling" she is trying to get the doc ' s orders followed. There is a difference.